Walker Type Recommendations for Children with Cerebral Palsy

Cerebral Palsy, as defined by the CDC, is “a group of disorders that affect a person’s ability to move and maintain balance and posture” and is “caused by abnormal brain development or damage to the developing brain that affects a person’s ability to control his or her muscles,” as well as causes muscle weakness.^[1]

Cerebral palsy is a common motor disability encountered in pediatric physical therapy. Depending on the GMFCS Level, a child may benefit from a walker to help ease the strain of walking, increase stability and posture, and reduce energy costs.

Walker Types

The purpose of a walker is to provide support and balance and serve as a weight-bearing mechanism.

The two main types of walkers are anterior walkers and posterior walkers. Anterior walkers have the frame in the front, while posterior walkers have the frame in the back. Walkers can have various features such as two wheels and two legs, all four wheels, forearm supports, seats, or whatever the child requires. However, the type of walker (anterior vs. posterior) is significant.

An anterior walker has the child lean forward onto the walker, shifting their center of gravity forward and leaning at the hips. 

The posterior walker has the child lean backward on it, and the walker itself supports the center of gravity. This walker promotes better posture as the whole body is extended to walk.

Recommendations

The study concluded that the posterior walker is recommended in most cases “it provides the better gait pattern and is less energy consuming. The child who walks slowly in a high guard position and falls backward after a few steps would benefit from a posterior walker as it provides an upright position and the frame in the back helps to protect the child.”²

However, it is essential to remember that each child is different and has different needs in terms of how a walker supports their body. Although many CP patients prefer a posterior walker, it is not necessarily the best option. The child’s gait pattern, GMFCS level, strengths, and weaknesses must be examined before deciding which walker is best for them.

• In-Text Citations

  1. CDC

  2. Tao, et al, p.889.

• Sources

  Poole, Marilyn et al. “Anterior or posterior walkers for children with cerebral palsy? A systematic review.” Disability and rehabilitation. Assistive technology vol. 13,4 (2018): 422-433. doi:10.1080/17483107.2017.1385101

  Tao, Ran, Li Feng, Zhen Xiao, and Bei-hua Zhang. 2020. “Posterior Versus Anterior Walkers for Children with Cerebral Palsy-Biomechanical Analysis and Energy Consumption: A Systematic Review.” Journal of Developmental and Physical Disabilities 32 (6): 877–92. doi:10.1007/s10882-020-09731-3.

  “What is Cerebral Palsy,” CDC, accessed 27 September 2022, https://www.cdc.gov/ncbddd/cp/facts.html